SVO 170004 - Guide to better learning from incidents in the (petrochemical) industry. A more difficult task than often thought
[ Source: Veiligheid Voorop, https://veiligheidvoorop.nu/ ]
Summary
In order to strengthen environmental safety, it is important to learn from one's own incidents, near misses and unsafe situations. Incidents at other companies can also be instructive. Especially when it concerns companies with high-risk processes and hazardous substances.
An incident may reveal a weakness in a safety management system. Investigating the incident increases the understanding of this system. If necessary, action can then be taken to improve deficiencies in the system.
In practice, it has been observed repeatedly that there are serious barriers to the sharing of information about incidents and near misses. This is the case in the exchange of safety information between companies and between companies and supervisory authorities. By removing a number of identified barriers, including the 'risk-rule reflex' and the 'transparency paradox', the learning process can be optimised. Obviously, this is only possible if a company first learns from its own accidents.
The VNCI, together with the six regional safety networks and the Stichting Veiligheid Voorop, has taken the initiative to start the project "learning from incidents" with a number of Brzo companies via a Safety Deal (SVO 170004). Research bureau Crisislab is the executor of this project. The end result is this guide describing design principles at three levels, resulting in a concrete step-by-step plan for organisations that want to learn effectively from incidents.
